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18A.3 Health effects of various forms of smokeless tobacco
Foreword

Relevant news and research: Health effects of various forms of smokeless tobacco

Ahsan, Z., Almas, A., Iqbal, R., Ahmed, S., Tikmani, S. S., Jamil, Z., Ahmed, F., Jakhro, S., Qureshi, K., Dars, S., Rahim, A. and Ali, S. A. (2025). Patterns and association between smokeless tobacco consumption and hemoglobin level among 6 to 12 years children: analytical cross-sectional study : Association between smokeless tobacco use and hemoglobin in rural Pakistani children. J Health Popul Nutr, 1, 395. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41219788


Cheng, H. G., Noggle, B. and Flora, J. W. (2025). Comparative disease risks associated with cigarette smoking and use of moist smokeless tobacco and snus: an umbrella review of epidemiological evidence from the United States and Western Europe. BMC Public Health, 1, 3765. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41184935


Rantasa, M., Majer, D. and Finsgar, M. (2025). A Review of Analytical Techniques for the Analysis of Oral Smokeless Products and Heated Tobacco Products. Crit Rev Anal Chem, 1-19. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41217039


S, S., Baseer, N., Shahzad, M. and Safi, S. (2025). Programmed death-ligand 1 (PDL-1) expression in the oral mucosa of smokeless tobacco users from a low and middle-income country. J Stomatol Oral Maxillofac Surg, 3, 102665. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41285245


Samantaray, S. S., Patra, P., Panda, S. S., Panda, P., Dash, B. K., Patil, S. P. and Budukh, A. M. (2025). Management of tobacco pouch keratosis in the tribal area of Mayurbhanj, India. Can J Dent Hyg, 3, 224-227. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41195318


Bogdanska, K., Kubik, M., Mazur, M., Dudek, A., Szkudlarek, W., Bogdanski, A., Bursy, M., Linkiewicz, J. and Bogdanska, A. (2025). Oral Health Consequences of Smokeless Tobacco Use: A Narrative Review. Cureus, 9, e92625. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41111690


Jalbani, N. B., Solangi, S. H., Bhutto, S., Min, H. S., Khan, H., Nawaz, H. R., Bhatti, M. and Imad, S. (2025). Health risk assessment and trace element analysis in tobacco products and user blood samples from urban and rural Karachi. Sci Rep, 1, 34229. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41034478


Ullah, M. Z., Lim, J. N., Chrysanthou, M., Rahman, M. M., Arefin, M. S., Dhar, A. and Shahriar, M. S. H. (2025). Smokeless Tobacco Usage and Oral Cancer Risk: A Hospital-Based Case-Control Study From Bangladesh. Tob Use Insights, 1179173X251383752. Available from: https://www.ncbi.nlm.nih.gov/pubmed/41048482


McKinney, R., Buhler, C. and Brizuela, M. (2025). Smokeless Tobacco Oral Pathology. StatPearls. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34424631


Siddiqui, L. T., Yadadi, S. S., Acharya, A. B., Mohammed, M. M., Shehadat, S. A., Vinay, V., Desai, V. and Shetty, R. M. (2025). Prevalence of smokeless tobacco use and its impact on periodontal health among adults in Rajnandgaon, Chhattisgarh, India: a cross-sectional study. Front Oral Health, 1659319. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40978158


Sivaramakrishnan, G. and Sridharan, K. (2025). Prevalence of Oral Potentially Malignant Disorders in Smokeless Tobacco Users With or Without Areca Nut: A Meta-Analysis. J Oral Pathol Med. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40891099


Banik, A., Rupani, M. P., Trivedi, A. V. and Dave, J. D. (2025). Use of smokeless tobacco by patients with drug-sensitive pulmonary tuberculosis: The need for strengthening tuberculosis-tobacco collaborative in India. Natl Med J India, 3, 138-143. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40826968


Ezhilarasan, D. and Jayanth Kumar, V. (2025). Toxicological Impacts of Arecoline and Tobacco in Oral Submucous Fibrosis: Mechanisms and Therapeutic Insights. J Appl Toxicol. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40763929


Kathuria, N. S., Kaur Sidhu, G., Kathuria, N. S., Kaur, A., Sudan, P. and Sharma, P. (2025). Cardiovascular profile and oral submucous fibrosis among long-term tobacco chewers. Bioinformation, 5, 1201-1206. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40822796


Kerketta, A. S., Panda, A., Parida, J., Nath, B., Swain, S., Sharma, A. K., Singh, P. K., Singh, S., Pati, S. and Acharya, S. K. (2025). Patterns and influencing factors of smokeless tobacco use among pregnant and lactating mothers in urban slums of bhubaneswar, Odisha. Sci Rep, 1, 30242. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40825994


Nath Barbhuiya, S., Barhoi, D., Dey, P., Giri, A. and Giri, S. (2025). Curcumin and quercetin can ameliorate arsenic and smokeless tobacco induced reproductive toxicity in female mice. Drug Chem Toxicol, 15-Jan. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40824744


Dalirsani, Z., Ghazi, A., Pakfetrat, A., Jamali, J., Foroughi, Z. and Mirzaei, M. (2025). The Relationship Between Smokeless Tobacco and the Incidence of Oral Cancer: A Systematic Review Study. Addict Health, 1522. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40666083


Ghosh, A., Singh, S., Mallick, T. R., Chakravarty, S., Varsha Bhagat, S., Das, C., Gopinath, K. S., Mohiyuddin, A., Maitra, A., Majumder, P. P., Kundu, T. K. and Biswas, N. K. (2025). Comprehensive genomic and digital pathology profiling of tobacco-chewer female oral cancer patients simultaneously with integration of single-cell datasets identifies clinically actionable patient subgroups. Clin Transl Med, 7, e70386. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40621643


Khnanisho, M. E., Holle, A. M., Tummala, S. V., Brinkman, J. C., Hattrup, S. J. and Tokish, J. M. (2025). Chewing tobacco use is associated with increased perioperative complications after arthroscopic rotator cuff repair. J Shoulder Elbow Surg. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40581083


Patil, V. R. and Sanjai, K. (2025). Impact of Smokeless Tobacco on Salivary Antioxidant Systems and Oral Health: A Comparative Study Among Individuals With and Without Tobacco Pouch Keratosis. Cureus, 6, e85229. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40605879


Iqbal, F., Ahmad, S., Maryam, H. and Amin, H. (2025). Evidence of mutations in tumour suppressor genes among oral cancer in Naswar, smokeless tobacco users. Acta Odontol Scand, 299-309. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40457841


Shaikh, R., Vogt, T., Saikia, N., Pednekar, M. S., Gupta, P. C. and Janssen, F. (2025). Mortality Fractions Attributable to Smoking and Smokeless and Mixed Tobacco Use among Men and Women across India, 1998-2021. Nicotine Tob Res. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40515622


Houter, E., Van Looij, M. A. J. and Kasius, K. M. (2025). Sleep, Shocks and SNUS: A Case Report on Nicotine-Induced Hypnic Jerks. J Sleep Res, e70077. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40342083


Sang, E., Silva, S., Grenon, S., Swinkels, C., Shakya, S., Deshmukh, S., Fish, L. J., Da Costa, M., Simmons, L. A., Severson, H. H., Pollak, K. I. and Noonan, D. (2025). Prevalence and predictors of chronic disease among rural and medically underserved populations using smokeless tobacco. Front Public Health, 1565910. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40416674


Abo-Zaid, M. A., Alfattah, M. A., Elashmawy, N. F., Hamdi, H. A., Yatimi, B. A., Hakami, L. A., Malhan, A. A., AlFaifi, T., Mashlawi, A. M., Areshi, S., Amin, A. H., Elazab, K. M., Ramadan, M. F. and Ismail, A. H. (2025). A comprehensive assessment of smokeless tobacco (Shammah) extract: unraveling the effects on hematological parameters, antioxidant defense mechanisms, and organ health in rats. J Mol Histol, 2, 130. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40186725


Af Geijerstam, P., Joelsson, A., Radholm, K. and Nystrom, F. H. (2025). Cardiovascular and metabolic changes following 12 weeks of tobacco and nicotine pouch cessation: a Swedish cohort study. Harm Reduct J, 1, 54. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40241094


Bandaranayake, C. A., Liyana Arachchige, A. P., Tilakaratne, A. and Jayasinghe, R. D. (2025). Association of smokeless tobacco with periodontal health of patients seeking treatment at a Dental Hospital setting in Sri Lanka. J Oral Biol Craniofac Res, 3, 570-575. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40224670


Francis, D. L., Pape Reddy, S. S., Rathi, M. and Chopra, S. S. (2025). From periodontal inflammation to oral cancer: the impact of smokeless tobacco. Lancet Reg Health Southeast Asia, 100574. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40241691


Gupta, A., Gawde, N., Kumar, K. A., Sivakami, M. and Parasuraman, S. (2025). Life within: Unraveling the patterns and correlates of smokeless tobacco use in pregnant women across India. Public Health, 359-366. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40187342


Taha, M. M. E., Abdelwahab, S. I., Oraiby, M. and Al-Zubairi, A. S. (2025). Heavy Metals, Active Ingredients, and Adulteration Smokeless Tobacco Varieties: a Chemometrics Based on Principal Components and Hierarchical Cluster Analysis. Biol Trace Elem Res. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40240668


Rezaeian, M., Ahmadinia, H., Rabori, M. S., Dini, A., Esmaeili, A., Mohammadi, H. and Ghaffarian-Bahraman, A. (2025). Human health risk assessment of toxic metals in Nass smokeless tobacco in Iran. Sci Rep, 1, 9525. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40108331


Vaishnav, B., Valiyil, A. S., Anand, S., Ghosal, A., Pailla, R. and Nair, G. R. (2025). Effects of Smokeless Tobacco Use on the Upper Gastrointestinal Tract Mucosa: Gross and Histopathological Changes. Ann Afr Med. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40041938


Vanderham, L. C., Vallabhaneni, N., Moore, J. W., Guareschi, A. S., Rogalski, B. L., Eichinger, J. K. and Friedman, R. J. (2025). Effects of Smokeless Tobacco Use on Primary Total Shoulder Arthroplasty Outcomes. J Shoulder Elbow Surg. Available from: https://www.ncbi.nlm.nih.gov/pubmed/40158882


Mehrotra, R. and Lauby-Secretan, B. (2025). Smokeless Tobacco Is a Major Risk Factor for Oral Cancer in South and Southeast Asia. Oral Dis. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39928051


Mitra, S., Hasan, I. and Chowdhury, J. A. (2024). Smokeless Tobacco use in Bangladesh: A Prime Concern to Address. WHO South East Asia J Public Health, 2, 96-97. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39995009


Parihar, A. S., Chakraborty, A., Pidaparthi, A., Kaur, G., Bhatt, S. and Handa, A. (2024). Association between Oral Cancer and Smokeless Tobacco Use in Rural Indian Men: A Prospective Cohort Study. J Pharm Bioallied Sci, Suppl 4, S3768-S3771. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39926943


Rahman, I., Ahmad, F. and Sadiq, N. (2025). Smokeless, not harmless: Understanding Naswar's cardiovascular risks in the northwestern Pakistan. Prev Med Rep, 102963. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39897735


Rathi, A., Khanam, A., Khan, H., Aatif, M., Farhan, M., Sharma, R. K., Himanshu, Kumar, P. and Husain, A. (2025). A comprehensive review: role of smokeless tobacco consumption as a risk factor for diabetes mellitus. Acta Diabetol. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39903244


Shah, K., Boffetta, P. and Seyyedsalehi, M. S. (2025). Reversal of head and neck cancer risk after the cessation of use of smokeless tobacco and betel quid use: meta-analysis. Cancer Epidemiol Biomarkers Prev. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39964748


Holle, A. M., Tummala, S. V., Pejic, J., Van Schuyver, P. R., Chhabra, A. and Economopoulos, K. J. (2025). Association of Smokeless Tobacco Use With Perioperative Complications and Revision Surgery After Anterior Cruciate Ligament Reconstruction. Am J Sports Med, 3635465241303487. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39754412


Mahajan, A., Gupta, B. and Tong, M. (2024). The invisible enemy: A systematic review and meta-analysis of maternal smokeless tobacco use as a risk factor for low birth weight. PLoS One, 12, e0312297. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39775175


Majrashi, N. A., Alyami, A. S., Almansour, M. A., Alyami, M. H., Almansour, M. H., Alhashlan, E., Shubayr, N., Hendi, A. M., Ageeli, W. A., Madkhali, Y., Alwadani, B., Refaee, T. A. and Waiter, G. D. (2025). Differences in Brain Volume and Thickness between Shammah (Smokeless Tobacco) Users and Non-Users: A Cross-Sectional Study. Br J Hosp Med (Lond), 1, Jan-18. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39862043


Tasdighi, E., Yao, Z., Jha, K. K., Dardari, Z. A., Osuji, N., Rajan, T., Boakye, E., Rodriguez, C. J., Matsushita, K., Simonsick, E. M., Lima, J. A. C., Widome, R., Cohen, D., Appel, L. J., Khera, A., Hall, M. E., Judd, S., Cole, S. A., Ramachandran, V. S., Benjamin, E. J., Bhatnagar, A., DeFilippis, A. P. and Blaha, M. J. (2025). Cigar, Pipe, and Smokeless Tobacco Use and Cardiovascular Outcomes From Cross Cohort Collaboration. JAMA Netw Open, 1, e2453987. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39804647


Yao, Z., Tasdighi, E., Dardari, Z. A., Jha, K. K., Osuji, N., Rajan, T., Boakye, E., Rodriguez, C. J., Matsushita, K., Simonsick, E. M., Lima, J. A. C., Widome, R., Cohen, D. L., Appel, L. J., Khera, A., Hall, M. E., Judd, S., Cole, S. A., Vasan, R. S., Benjamin, E. J., Bhatnagar, A., DeFilippis, A. P. and Blaha, M. J. (2025). Differential Associations of Cigar, Pipe, and Smokeless Tobacco Use Versus Combustible Cigarette Use With Subclinical Markers of Inflammation, Thrombosis, and Atherosclerosis: The Cross-Cohort Collaboration-Tobacco Working Group. Circulation. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39866105


Dallak, F. H., Alharbi, F. A., Alhazmi, A. H., Abusageah, F., Durayb, A. A., Almalki, N. M., Tayrah, F. A. A., El-Setouhy, M., Dallak, R. H. and Shami, R. M. (2024). Community awareness regarding smokeless tobacco (Shamma) as a cause of oral cancer in Jazan region, Saudi Arabia: A cross-sectional study. J Family Med Prim Care, 11, 4885-4893. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39722995


Hassan, S., Sifat, A., Munib, M., Saeed, S., Nisa, W. U., Durrani, S. H., Rahim, A., Ullah, N., Afaq, S., Ali Khattak, F. and Haq, Z. U. (2024). Cytomorphological changes of oral mucosal cells among smokeless tobacco users in low and middle-income country settings: new findings from Pakistan. BMC Oral Health, 1, 1541. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39710646


Htay, Z. W., Bhandari, A. K. C., Parvin, R. and Abe, S. K. (2024). Effects of smokeless tobacco on cancer incidence and mortality: a global systematic review and meta-analysis. Cancer Causes Control. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39718727


Motlhale, M., Sitas, F., de Villiers, C. B., Simba, H., Feliu, A., Chen, W. C., Schuz, J., Muchengeti, M. and McCormack, V. (2024). Smokeless tobacco (snuff) and site-specific cancer risks in adult Black South African women: Findings from the Johannesburg Cancer Study. Int J Cancer. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39679969


Zhang, M., Cheng, H. G., Noggle, B., Janak, J. C., Richards, M. and Smith, D. (2024). Assessing healthcare cost changes associated with transitioning away from cigarette smoking using healthcare claims data: an exploratory study among adult male patients with COPD. Harm Reduct J, 1, 227. Available from: https://www.ncbi.nlm.nih.gov/pubmed/39716190


Earlier news and research

For news items and research on this topic earlier than 2025, click here.

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Chapter 2